Dr. Benjamin Druss, who holds the Rosalynn Carter Chair of Mental Health in Emory's Rollins School of Public Health, says these findings "show how the health workforce has evolved during a time of great change in the US health system. Patients are increasingly treated by multiple providers, who have a range of training and philosophical approaches to treatment." Dr. Druss and co-authors from Columbia University, the University of Pennsylvania, the University of Pittsburgh, and RAND are publishing their findings in the January 9, 2003 issue of the New England Journal of Medicine.
They cite data showing that in the 10-year study period, non-physicians were more likely to provide preventive services, less likely to provide acute care (diagnosis and treatment for specific illnesses), and more likely to work in the same location as a physician, suggesting that they may be working conjointly with physicians to care for patients.
The study draws on more than 40,000 individuals interviewed in national medical surveys conducted in 1987 and 1997. The decade under review was one in which there was an increase in the number of non-physician clinicians graduating from training programs, in state laws allowing non-physicians a greater scope of clinical practice, and in managed care plans that used these providers to control costs.